Femoral aseptic pseudarthrosis with implant failure –cases presentation

Abstract

Objective Management of the femoral implant failure is one the hardest situation faced in traumatology. Our study try to understand the causes which lead to pseudarthrosis after primary osteosynthesis of femoral fracture with breakage of the implant and to establish a therapeutical protocol which can be applied to these cases. Material. Methods. We performed a retrospective study between 2011 and 2014, analyzing all patients with femur fractures treated in our hospital or in other hospitals but which came in our Clinic with pseudarthrosis and implant failure or breakage. Results A total of cases were introduced in our study: 2 trochanteric fractures, 3 trochantero-diaphiseal fractures, 2 diaphiseal fractures, 1 distal periprothetic fracture, 1 supracondylar fracture. Every case had own particularities and the therapeutical stages were: choice of surgical approach, method of implant ablation with minimal bone loss, more stable osteosinthesis, bone graft. The time of the operation should be as short as possible to minimize infection risk. Conclusions Pseudarthrosis of the femoral fracture with breakage of the implant is a tough situation for any surgeon. Understanding the causes which produced the implant failure and establishing a therapeutical strategy to correct them are the goal of the treatment.